Emergency Medicine Greece

Januray 22nd, 2020 – Misconceptions

Hello,

This week’s newsletter focuses on some misconceptions and common errors that lead to the spread of COVID-19. As always if you were forwarded this newsletter and would like to receive it weekly, you may register for free here.

Sam


1) I was more than 6 feet away…

The 6 foot recommendation from the CDC was originally based upon early studies that suggested droplets from a cough would only travel 6 feet before falling to the ground. Since that time, multiple studies have suggested that this distance is dependent on many other factors. Air movement (ventilation), masks, presence of cough or singing, and duration of exposure to name a few. These factors allow for someone to be “exposed” while indoors or in a confined space, even when farther than 6 feet. So no, you are not safe just because you are 6 feet away from someone infected with COVID-19, especially indoors.


2) I feel fine…

Many people will note that they feel fine after an exposure and therefore do not need to quarantine. This is problematic. People who have been exposed are asked to quarantine in order to monitor for symptoms. We know that people are contagious starting 2 days before symptoms of covid show up. So just because someone feels fine now, does not mean they are not infected and contagious. Exposure should prompt quarantine.


3) I was wearing a mask…

Wearing a mask is effective in reducing the spread of COVID-19. However, people must still quarantine after an exposure regardless of mask use. The best masks form a seal around a person’s mouth and nose. In healthcare, workers are “fit tested” to be sure an appropriate seal is achieved. It is not possible to do this for every person in the country. Non-healthcare masks vary greatly in thickness, material, fit, and quality. Also, they do not undergo the same standard testing as healthcare certified masks. Therefore, it is still possible to become infected even with a mask on. Quarantine is still required after exposure despite use of a mask.


4) We were all outdoors…

Ventilation, especially natural air movement, is helpful. But it isn’t a guaranteed method of preventing COVID-19 spread. In fact, many people become infected because they mistakingly spend too much time in close proximity to someone outdoors, talking without a mask. This is still a high risk scenario. Natural air movement (a stiff breeze) is helpful, but it is only one part of a multi-step approach to preventing infection. The best scenario is being outdoors with a mask, more than 6 feet apart.


5) I only have some mild congestion…

Many people have no symptoms at all with COVID-19. You do not need to be deathly ill, or even have a fever. A mild headache or nasal congestion may be all that you experience. If you have any one of the symptoms of COVID-19, you should isolate and get tested. Do not assume you have something else. Assume you have COVID until proven otherwise.


6) My test hasn’t come back yet, so I’m good…

No. If you have been tested and are waiting for results, assume you are positive. Stay home and isolate.


7) We were only together for 2 minutes at a time…

The CDC guidelines define exposure as a total of 15 min, less than 6 feet apart. The 15 minutes is cumulative in a 24 hours period. Why? Because we have documented cases of people spending multiple short periods of time together, and still passing along the infection. So the 15 minutes does not have to be consecutive.


8) I was wearing a mask, 6 feet apart, and doing all the right things…

Yes, unfortunately, there are still instances when people become infected despite taking all the appropriate measures. Nothing is 100%, but the more measures you abide by (time, distance, ventilation), the better your chances of staying healthy.


9) It has been 10 days, so I’m good…

Yes, probably. Most people have complete resolution of their symptoms within 10 days. A small percentage will take up to 14 days. An even smaller percentage will have persistent symptoms and may still be contagious up t0 20 days. This occurs in people sever illness, those with immune system problems or those taking medications to suppress their immune system, like steroids or chemotherapy. You must be symptom free in order to end isolation. The only exception is the loss of smell and taste, which may persist even after someone is no longer contagious.

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